News Abortion

Abby Johnson Explains To CPCs How To Use Forced Ultrasound Bills To Lie and Get Women In the Door

Robin Marty

If you wondered why ultrasound bills are popping up everywhere, it's to open the door for more opportunities to trick women into visiting crisis pregnancy centers.

When Idaho’s anti-choice legislators proposed their mandatory ultrasound bill, one of the hopes was that women would go to crisis pregnancy centers to obtain free ultrasounds, despite the fact that those ultrasounds wouldn’t count as the mandatory ultrasounds required by the bill. When asked why he was essentially proposing two different ultrasounds, the bill’s sponsor, Senator Chuck Winder, seemed genuinely confused by the question, not completely positive whether he was proposing two or not.

Now, it’s a little easier to understand why he didn’t know.  Anti-choice activists are purposefully trying to use ultrasounds as a means to get women who are considering abortion into crisis pregnancy centers, misleading them into thinking that they are going to receive free, necessary ultrasounds that they will need to have before they terminate their pregnancies.

At the annual conference for crisis pregnancy centers, former Planned Parenthood employee turned anti-choice personality Abby Johnson explains to attendees how to use ultrasounds and other means to mislead women into coming into crisis pregnancy centers so they can be talked out of having abortions.

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News Abortion

Idaho Directs Pregnant People to Fake Clinics for Free Ultrasounds

Nicole Knight

The state health department doesn't screen the providers, which "gives the false impression that this is a vetted list …when it’s actually not," as Hannah Brass Greer, Idaho legislative director of Planned Parenthood Votes Northwest and Hawaii, told Rewire.

Idaho’s health department is now sending patients seeking abortion care to fake clinics, also known as crisis pregnancy centers, thanks to a new Republican-backed law promoting free ultrasound providers.

The law, HB 516, amends an existing statute to require the state Department of Health and Welfare to compile a list of providers of free ultrasounds. The agency must also let pregnant people know they have the “right to view an ultrasound image and hear heart tone monitoring.”

The health department, however, doesn’t screen the providers, which “gives the false impression that this is a vetted list …when it’s actually not,” as Hannah Brass Greer, Idaho legislative director of Planned Parenthood Votes Northwest and Hawaii, told Rewire.

Getting included on the list simply requires contacting the health department, and all of the 11 providers now on it are anti-abortion facilities. As Brandi Swindell, CEO of Stanton Healthcare, which has two clinics on the list, told the Associated Press, “I’m 100 percent pro-life.”

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When Rewire reached Sherry Bushnell at A Blessed Beginning, which is also included on the health department’s list, she said they actually don’t provide free ultrasounds right now because their ultrasound facility is “under construction.” She said they refer clients to Life Choices, in nearby Sandpoint, Idaho.

Like most anti-choice clinics, A Blessed Beginning espouses unscientific claims about the psychological risks of abortion care. Its website warns that abortion causes everything from eating disorders to suicidal thoughts, although peer-reviewed studies have found no link between abortion care and depressionanxiety, or post-traumatic stress disorder.

The health department issued the list August 1, and it includes facility names, addresses, contact information, and hours. One of the clinics is actually in Washington state, not Idaho. Planned Parenthood isn’t included because it does not offer free ultrasounds, though representatives from the organization told Rewire it does offer financial assistance to those in need.

Buried at the bottom of the four-page list is a small disclaimer that says, in part:

This information is not intended to constitute medical advice or the provision of medical services …. The Department of Health and Welfare does not inspect, certify, or endorse any of the providers listed and cannot be held liable for the action(s) of said providers.

“Adding that language was a way to let people know that we’re not saying this is going to be a great ultrasound experience,” health department spokesperson Niki Forbing-Orr told the Associated Press. “There’s no registry for this type of equipment in Idaho. Anyone can own and operate one.”

As Rewire previously reported, one of the clinics on the health department list is directly connected to Rep. Vito Barbieri (R-Dalton Gardens), who voted in favor of the legislation. In 2014, Barbieri was president of the board of directors of Open Arms PCC and Real Choices Clinic, which is included on the health department’s list.

Analysis Law and Policy

After ‘Whole Woman’s Health’ Decision, Advocates Should Fight Ultrasound Laws With Science

Imani Gandy

A return to data should aid in dismantling other laws ungrounded in any real facts, such as Texas’ onerous "informed consent” law—HB 15—which forces women to get an ultrasound that they may neither need nor afford, and which imposes a 24-hour waiting period.

Whole Woman’s Health v. Hellerstedt, the landmark U.S. Supreme Court ruling striking down two provisions of Texas’ omnibus anti-abortion law, has changed the reproductive rights landscape in ways that will reverberate in courts around the country for years to come. It is no longer acceptable—at least in theory—for a state to announce that a particular restriction advances an interest in women’s health and to expect courts and the public to take them at their word.

In an opinion driven by science and data, Justice Stephen Breyer, writing for the majority in Whole Woman’s Health, weighed the costs and benefits of the two provisions of HB 2 at issue—the admitting privileges and ambulatory surgical center (ASC) requirements—and found them wanting. Texas had breezed through the Fifth Circuit without facing any real pushback on its manufactured claims that the two provisions advanced women’s health. Finally, Justice Breyer whipped out his figurative calculator and determined that those claims didn’t add up. For starters, Texas admitted that it didn’t know of a single instance where the admitting privileges requirement would have helped a woman get better treatment. And as for Texas’ claim that abortion should be performed in an ASC, Breyer pointed out that the state did not require the same of its midwifery clinics, and that childbirth is 14 times more likely to result in death.

So now, as Justice Ruth Bader Ginsburg pointed out in the case’s concurring opinion, laws that “‘do little or nothing for health, but rather strew impediments to abortion’ cannot survive judicial inspection.” In other words, if a state says a restriction promotes women’s health and safety, that state will now have to prove it to the courts.

With this success under our belts, a similar return to science and data should aid in dismantling other laws ungrounded in any real facts, such as Texas’ onerous “informed consent” law—HB 15—which forces women to get an ultrasound that they may neither need nor afford, and which imposes a 24-hour waiting period.

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In Planned Parenthood v. Casey, the U.S. Supreme Court upheld parts of Pennsylvania’s “informed consent” law requiring abortion patients to receive a pamphlet developed by the state department of health, finding that it did not constitute an “undue burden” on the constitutional right to abortion. The basis? Protecting women’s mental health: “[I]n an attempt to ensure that a woman apprehends the full consequences of her decision, the State furthers the legitimate purpose of reducing the risk that a woman may elect an abortion, only to discover later, with devastating psychological consequences, that her decision was not fully informed.”

Texas took up Casey’s informed consent mantle and ran with it. In 2011, the legislature passed a law that forces patients to undergo a medical exam, whether or not their doctor thinks they need it, and that forces them to listen to information that the state wants them to hear, whether or not their doctor thinks that they need to hear it. The purpose of this law—at least in theory—is, again, to protect patients’ “mental health” by dissuading those who may be unsure about procedure.

The ultra-conservative Fifth Circuit Court of Appeals upheld the law in 2012, in Texas Medical Providers v. Lakey.

And make no mistake: The exam the law requires is invasive, and in some cases, cruelly so. As Beverly McPhail pointed out in the Houston Chronicle in 2011, transvaginal probes will often be necessary to comply with the law up to 10 to 12 weeks of pregnancy—which is when, according to the Guttmacher Institute, 91 percent of abortions take place. “Because the fetus is so small at this stage, traditional ultrasounds performed through the abdominal wall, ‘jelly on the belly,’ often cannot produce a clear image,” McPhail noted.

Instead, a “probe is inserted into the vagina, sending sound waves to reflect off body structures to produce an image of the fetus. Under this new law, a woman’s vagina will be penetrated without an opportunity for her to refuse due to coercion from the so-called ‘public servants’ who passed and signed this bill into law,” McPhail concluded.

There’s a reason why abortion advocates began decrying these laws as “rape by the state.”

If Texas legislators are concerned about the mental health of their citizens, particularly those who may have been the victims of sexual assault—or any woman who does not want a wand forcibly shoved into her body for no medical reason—they have a funny way of showing it.

They don’t seem terribly concerned about the well-being of the woman who wants desperately to be a mother but who decides to terminate a pregnancy that doctors tell her is not viable. Certainly, forcing that woman to undergo the painful experience of having an ultrasound image described to her—which the law mandates for the vast majority of patients—could be psychologically devastating.

But maybe Texas legislators don’t care that forcing a foreign object into a person’s body is the ultimate undue burden.

After all, if foisting ultrasounds onto women who have decided to terminate a pregnancy saves even one woman from a lifetime of “devastating psychologically damaging consequences,” then it will all have been worth it, right? Liberty and bodily autonomy be damned.

But what if there’s very little risk that a woman who gets an abortion experiences those “devastating psychological consequences”?

What if the information often provided by states in connection with their “informed consent” protocol does not actually lead to consent that is more informed, either because the information offered is outdated, biased, false, or flatly unnecessary given a particular pregnant person’s circumstance? Texas’ latest edition of its “Woman’s Right to Know” pamphlet, for example, contains even more false information than prior versions, including the medically disproven claim that fetuses can feel pain at 20 weeks gestation.

What if studies show—as they have since the American Psychological Association first conducted one to that effect in 1989—that abortion doesn’t increase the risk of mental health issues?

If the purpose of informed consent laws is to weed out women who have been coerced or who haven’t thought it through, then that purpose collapses if women who get abortions are, by and large, perfectly happy with their decision.

And that’s exactly what research has shown.

Scientific studies indicate that the vast majority of women don’t regret their abortions, and therefore are not devastated psychologically. They don’t fall into drug and alcohol addiction or attempt to kill themselves. But that hasn’t kept anti-choice activists from claiming otherwise.

It’s simply not true that abortion sends mentally healthy patients over the edge. In a study report released in 2008, the APA found that the strongest predictor of post-abortion mental health was prior mental health. In other words, if you’re already suffering from mental health issues before getting an abortion, you’re likely to suffer mental health issues afterward. But the studies most frequently cited in courts around the country prove, at best, an association between mental illness and abortion. When the studies controlled for “prior mental health and violence experience,” “no significant relation was found between abortion history and anxiety disorders.”

But what about forced ultrasound laws, specifically?

Science has its part to play in dismantling those, too.

If Whole Woman’s Health requires the weighing of costs and benefits to ensure that there’s a connection between the claimed purpose of an abortion restriction and the law’s effect, then laws that require a woman to get an ultrasound and to hear a description of it certainly fail that cost-benefit analysis. Science tells us forcing patients to view ultrasound images (as opposed to simply offering the opportunity for a woman to view ultrasound images) in order to give them “information” doesn’t dissuade them from having abortions.

Dr. Jen Gunter made this point in a blog post years ago: One 2009 study found that when given the option to view an ultrasound, nearly 73 percent of women chose to view the ultrasound image, and of those who chose to view it, 85 percent of women felt that it was a positive experience. And here’s the kicker: Not a single woman changed her mind about having an abortion.

Again, if women who choose to see ultrasounds don’t change their minds about getting an abortion, a law mandating that ultrasound in order to dissuade at least some women is, at best, useless. At worst, it’s yet another hurdle patients must leap to get care.

And what of the mandatory waiting period? Texas law requires a 24-hour waiting period—and the Court in Casey upheld a 24-hour waiting period—but states like Louisiana and Florida are increasing the waiting period to 72 hours.

There’s no evidence that forcing women into longer waiting periods has a measurable effect on a woman’s decision to get an abortion. One study conducted in Utah found that 86 percent of women had chosen to get the abortion after the waiting period was over. Eight percent of women chose not to get the abortion, but the most common reason given was that they were already conflicted about abortion in the first place. The author of that study recommended that clinics explore options with women seeking abortion and offer additional counseling to the small percentage of women who are conflicted about it, rather than states imposing a burdensome waiting period.

The bottom line is that the majority of women who choose abortion make up their minds and go through with it, irrespective of the many roadblocks placed in their way by overzealous state governments. And we know that those who cannot overcome those roadblocks—for financial or other reasons—are the ones who experience actual negative effects. As we saw in Whole Woman’s Health, those kinds of studies, when admitted as evidence in the court record, can be critical in striking restrictions down.

Of course, the Supreme Court has not always expressed an affinity for scientific data, as Justice Anthony Kennedy demonstrated in Gonzales v. Carhart, when he announced that “some women come to regret their choice to abort the infant life they once created and sustained,” even though he admitted there was “no reliable data to measure the phenomenon.” It was under Gonzales that so many legislators felt equipped to pass laws backed up by no legitimate scientific evidence in the first place.

Whole Woman’s Health offers reproductive rights advocates an opportunity to revisit a host of anti-choice restrictions that states claim are intended to advance one interest or another—whether it’s the state’s interest in fetal life or the state’s purported interest in the psychological well-being of its citizens. But if the laws don’t have their intended effects, and if they simply throw up obstacles in front of people seeking abortion, then perhaps, Whole Woman’s Health and its focus on scientific data will be the death knell of these laws too.

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